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Screening

Screening

This one-act play features a patient, former smoker, navigating the CMS rules for lung cancer CT screening in a shared decision-making session with his doctor.

Adding an MRI to a mammogram improved the sensitivity of breast cancer screening in women 50 years of age or older who are BRCA mutation carriers.

The use of a prostate cancer antigen 3 urine test could help men avoid undergoing unnecessary repeat biopsies, and predict which will be positive for cancer.

NLST data clearly demonstrate that lung cancer screening is effective and safe and reduces lung cancer-specific mortality by at least 20%. There is no possible reason for CMS to further delay or restrict lung cancer screening for those at high risk.

The development of CT lung cancer screening, the publication of results from the NLST in 2011, and the grade-B recommendation for CT lung cancer screening in high-risk smokers by the USPSTF raise a number of interesting national health policy issues.

The NLST is a landmark trial demonstrating that implementation of low-dose CT screening lowers lung cancer–related mortality. We must put the study results and cost-effectiveness analyses in the context of the staggering statistics: up to 65% of lung cancer patients present with advanced-stage disease where treatments are often costly, toxic, and only palliative in nature.

American medicine is poised for an expanded conflict over the assumption and consequences of risk in medical care.

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